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Dr Blewitt's letter makes several cogent and reasonable points about analgesic nephropathy. I certainly agree that more information and epidemiologic data are needed in the 1980s. In addition, I totally support the view that further experimental work is necessary to compare the safety and hazards of currently used analgesic components.I am not totally convinced that analgesic abuse nephropathy is a more appropriate term than analgesic associated nephropathy or just plain analgesic nephropathy. Not all patients reported as having this disorder have abused the drugs because of their own psychological needs or dysfunction. In some instances at least, the analgesic mixtures were prescribed or recommended by physicians or pharmacists. Hence, it is unfair (to the patient) to provide a "value-judgment term" in the formal diagnosis.The fact that phenacetin is not used much in the United States is not yet a cause for elation regarding analgesic nephropathy in
Goldberg M. Analgesic-Abuse Nephropathy-Reply. JAMA. 1982;248(9):1064. doi:10.1001/jama.1982.03330090035016
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